A Review of the Current Treatment of Tourette Syndrome

Abstract

Tourette syndrome is a hyperkinetic movement disorder that presents before age 18 years and involves motor and phonic tics that may present with a wide range of severity. The severity and presentation of tics in an individual may fluctuate over time. Tourette syndrome may affect social relationships and school attendance, and may result in depression. Comorbidities are common, with attention-deficit/hyperactivity disorder and obsessive-compulsive disorder being most common. The literature supporting optimal treatment is limited but provides a framework for clinical decision-making. The focus of this review is to discuss the symptoms and possible causes of Tourette syndrome and current non-pharmacologic and pharmacologic treatment options, to help practitioners optimize care for pediatric patients with this disease.

Fecal Microbiota Transplantation: A New Therapeutic Attempt from the Gut to the Brain

“…Tourette Syndrome (TS) is a neurodevelopmental disorder characterized by motor and speech tics in childhood [ 119 ]. Liao et al [ 120 ] found that probiotic supplementation improved tic-like behavior in mice, which coincided with an increased level of dopamine and norepinephrine.…”

Tourette Syndrome Treatment Updates: a Review and Discussion of the Current and Upcoming Literature

“…In spite of the widespread use of pharmacotherapy for the treatment of TS, there is a surprising lack of large, wellcontrolled studies for medication efficacy in TS [55]. Medications should be considered in patients if more conservative treatments such as behavioral interventions are ineffective or if the tics are severe [56 •].…”

Clinical development of valbenazine for tics associated with Tourette syndrome

“…In addition, DRBAs are associated with a risk of developing TD [17][18][19][20], although evidence from a large, retrospective chart review suggested that the incidence of TD may be lower in patients with TS than other patient populations [39]. Other off-label therapies for TS have shown only limited efficacy [2,5,[17][18][19]. Recent guidelines by the American Academy of Neurology did not find Level A evidence to recommend any available treatments for TS [17,18].…”

“…Most patients who present with tics before age 8 will experience a significant decrease in tic frequency during adolescence, often with a complete resolution of symptoms by adulthood [2,3]. TS can have a significant impact on the affected individual's functioning and quality of life and is often associated with comorbid psychiatric conditions such as attention deficit hyperactivity disorder (ADHD), obsessive compulsive disorder (OCD), anxiety, and depression [2,[5][6][7][8][9]. Many patients with TS experience high levels of distress, frustration, and hopelessness, and an increased risk of suicidal thoughts and behaviors [10,11].…”

“…alpha-2 adrenergic agonists, botulinum toxin, etc.) have been used for TS, but they have only limited efficacy [2,5,[17][18][19]. Thus, there is an unmet need for safer, more effective pharmacological treatments for TS.…”